ArticlePediatric transplantation2025
Performance of Donor-Derived Cell-Free DNA in Surveillance and For-Cause Biopsies in Pediatric Kidney Transplant Recipients.
Article in Pediatric transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- From Stable Values to Diagnostic Thresholds: Interpreting Donor-Derived Cell-Free DNA in Pediatric Kidney Transplantation.Pediatric transplantation · 2026Article
- Real-world utilization patterns and association of dd-cfDNA with biopsy and rejection.Frontiers in medicine · 2026Article
- Performance of Donor-Derived Cell-Free DNA in Surveillance and For-Cause Biopsies in Pediatric Kidney Transplant Recipients.Pediatric transplantation · 2025Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundDonor-derived cell-free DNA (dd-cfDNA), a biomarker demonstrated to increase with allograft injury, has been considered a possible diagnostic tool for allograft rejection in place of the current gold standard which is invasive kidney biopsies. We tested whether dd-cfDNA levels were predictive of rejection in our single-center cohort of pediatric kidney transplant (KT) recipients.
methodsAll primary pediatric KT recipients that had a dd-cfDNA level obtained within a month of any kidney biopsy, either surveillance or for-cause were included. Descriptive analysis was performed stratified by rejection status. Univariate analysis was performed to assess the association between median dd-cfDNA levels and rejection by each biopsy time point. dd-cfDNA levels were then further stratified by rejection type (no rejection, T-cell mediated, antibody mediated, or mixed). Diagnostic performance metrics of dd-cfDNA for detecting rejection were evaluated.
resultsForty pediatric KT recipients had 44 biopsies, 21 (48%) of which demonstrated rejection. Acute cellular, antibody-mediated, and mixed rejection occurred in 12 (57%), 6 (29%), and 3 (14%) respectively. The median dd-cfDNA level at the time of biopsy in those with and without rejection was 1.7 (95% CI: 0.2, 3.3) and 0.3 (95% CI: 0.2, 0.7), respectively (p = 0.15). dd-cfDNA levels prior to for-cause biopsies were significantly higher in patients with rejection (0.3 vs. 2.7; p = 0.02). dd-cfDNA levels at surveillance biopsies did not differ significantly by rejection status or type of rejection. dd-cfDNA levels ≥ 1 diagnosed rejection with a sensitivity of 52% and specificity of 83%.
conclusionsElevated dd-cfDNA levels were associated with rejection in for-cause biopsies but not in surveillance biopsies.
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